Chapter 29 Trauma to the Head, neck and spine

Question 1

What part of the nervous system controls involuntary functions?

Answer 1

Autonomic nervous system

Question 2

Nervous system

Answer 2

Provides overall control of thought, sensation, and the body’s voluntary and involuntary motor functions.

Question 3

What are the components of the nervous system?

Answer 3

Brain
Spinal cord
Nerves that innervate the body

Question 4

What are the two major subsystems of the nervous system?

Answer 4

Central and Peripheral Nervous System

Question 5

Neurons

Answer 5

specialized nerve cells that transmit nervous system impulses throughout the body

Question 6

What are some examples of bodily function that are under control of the autonomic nervous system?

Answer 6

Heartbeat
Breathing
Diameter of vessels
Control of sphincter muscles enclosing the bladder and digestion

Question 7

What are the bones of the cranium?

Answer 7

Frontal
Parietal
Occipital
Temporal 
Sphenoid

Question 8

How many bones make up the face?

Answer 8

14 irregularly shaped bones

Question 9

What are the major divisions of the skull?

Answer 9

Cranium and facial bones

Question 10

Which of the facial bones is not fused?

Answer 10

Mandible

Question 11

What are the immovable joints of the skull called?

Answer 11

sutures

Question 12

What are the cheek bones?

Answer 12

Malar (May-lar) aka Zygomatic bones/arches

Question 13

What is the opening at the base of the skull through which the spinal cord passes from the brain?

Answer 13

Foramen Magnum

Question 14

What is the lower end of the spinal cord called that fans out like a horses tail?

Answer 14

Cauda Equina

Question 15

What is the protective covering over the brain?

Answer 15

Meninges

Question 16

What are the irregularly shaped bones that protect the spinal cord?

Answer 16

Vertebrae (33 total)

Question 17

What is the palpable bony prominence attached to each vertebrae?

Answer 17

Spinous process

Question 18

What are the five areas that the vertebrae are divided into?

Answer 18

Cervical - 7
Thoracic - 12
Lumbar - 5
Sacral - 4
coccygeal - 4

Question 19

How do we treat scalp injuries?

Answer 19

Direct pressure unless bone fragments or depression of bone - use loose gauze instead

Question 20

What is an indirect brain injury?

Answer 20

shock of impact on the skull is transferred to the brain (concussions and contusions)

Question 21

What is the first and most significant sign of head injury?

Answer 21

Altered mental status, never assume a patient with an altered mental status is intoxicated or on drugs

Question 22

Traumatic Brain Injury?

Answer 22

An injury that disrupts the normal functioning of the brain

Question 23

Concussion

Answer 23

Mild closed head injury without detectable damage to the brain. Complete recovery is usually expected but effects can linger for weeks, months even years

Question 24

TBI accounts for slight more than ______ of injury related deaths

Answer 24

1/3

Question 25

What are the signs and sxs of concussion according to the CDC?

Answer 25

``` LOC Amnesia Repetitive Questioning Altered level of consciousness Feeling slugish Difficulty concentrating Feeling off Slurred speech, headache, nausea, blurred vision Sensitivity to light and noises ```

Question 26

Coup, contrecoup

Answer 26

Coup - injury to brain on side that sustained the blow | Contrecoup - injury to other side of the brain

Question 27

What are the TBIs?

Answer 27

Concussion Contusion Laceration Hematoma

Question 28

How does the body's blood pressure usually respond in the person with increased ICP?

Answer 28

Blood pressure increases

Question 29

Cushing's Reflex

Answer 29

Increased blood pressure and bradycardia indicating increased ICP

Question 30

Cheyne-Stokes Breathing

Answer 30

Distinct pattern of breathing characterized by quickening and deepening respiration followed by a period of apnea

Question 31

Central neurogenic hyperventilation

Answer 31

A pattern of rapid and deep breathing caused by injury to the brain

Question 32

Ataxic respiration

Answer 32

A pattern of irregular and unpredictable breathing commonly caused by brain injury

Question 33

How do you treat an impaled object in the skull?

Answer 33

Stabilize in place with bulky dressing. If too large, pad around, stabilize object on both sides of where it is to be cut, cut using something that will not cause vibration/movement

Question 34

What are some signs of facial fx?

Answer 34

``` discoloration of eye deformity Facial bruises loose, missing are improperly aligned teeth Swollen jaw ```

Question 35

What is the primary concern for patients with facial fx?

Answer 35

airway

Question 36

What is used in addition to AVPU for ongoing neurological assessment?

Answer 36

GCS

Question 37

What are the three sections of the GCS?

Answer 37

Eyes Verbal Motor

Question 38

What is the breakdown of the eye of the GCS?

Answer 38

spontaneous - 4 voice - 3 pain - 2 none - 1

Question 39

What is the breakdown of the verbal response of the GCS?

Answer 39

``` oriented - 5 confused - 4 inappropriate words - 3 incomprehensible sounds 2 none - 1 ```

Question 40

What is the breakdown of the motor response of the GCS?

Answer 40

``` obeys commands - 6 localizes pain - 5 withdraws - 4 Flexion - 3 Extension - 2 none - 1 ```

Question 41

In additions to massive hemorrhage, what is a concern when a patient is bleeding from a large neck vein?

Answer 41

air embolism, pressure in vein is lower than atmospheric pressure, sucking air in

Question 42

How do you treat an open neck wound?

Answer 42

place gloved hand over the wound Apply occlusive dressing 2" past the sides of the wound, all 4 sides sealed place dressing over occlusive dressing apply pressure, careful not to compress both carotid arteries

Question 43

What are the two broad classifications of spinal injury?

Answer 43

Primary and Secondary

Question 44

What two things will the EMT use to determine if a patient has a potential spinal injury?

Answer 44

MOI and Physical assessment | MOI must be paired with physical assessment

Question 45

What are common spine injuries that involve the spine being moved beyond it's normal ROM?

Answer 45

Flexion and extension injuries like whiplash

Question 46

What term describes the spine being excessively compressed?

Answer 46

axial loading

Question 47

What type of spinal injury happens with a hanging?

Answer 47

distraction

Question 48

What condition causes the vertebrae to fuse together?

Answer 48

ankylosing spondylitis